Clinical Analysis of 20 Cases with Pseudomonas Corneal Ulcers in Contact Lens Wearers / 감염

ABSTRACT

BACKGROUND: The number of reported cases of contact lens related ulcerative keratitis has markedly increased. Pseudomonas aeruginosa is one of the most virulent pathogen in contact lens wearers with corneal ulcer. It causes a rapidly spreading ulcer with copious mucopurulent discharge and occasionally corneal perforation. We analyzed the clinical and microbiological findings of 20 cases of culture-proven pseudomonas keratitis in contact lens wearers with a brief review of literature. METHODS: Twenty cases of Pseudomonas keratitis in contact lens wearers were reviewed retrospectively. All patients were seen at the department of ophthalmology, Konyang Hospital during the period from April 1994 to September 1997. RESULTS: The male to female ratio was 9 to 11. The age distribution ranged from 16 to 64 years 10 patients in their 20s, 7 in their 30s, and each in their 10s, 50s, and 60s, respectively. The duration of lens wear before developing keratitis was variable from 5 weeks to 12 years. Seven cases(35%) of them had a history of over night wearing of contact lens. The size of corneal ulcer varied from 1 to 8 mm in the longest diameter. Hypopyon was seen in 80% of patients. Almost all P. aeruginosa were resistant to ampicillin, cephalothin, chloramphenicol, and carbenicillin, but susceptible to imipenem, ciprofloxacin, and piperacillin. CONCLUSION: Pseudomonas keratitis is a rapidly spreading ulcer with various complications. It has markedly increased in contact lens wearers. To prevent further increase, education, early diagnosis, and treatment are important.